Evidence for the Link Between Psoriasis and Inflammatory Bowel Disease

The first epidemiological evidence from 1968 reported a prevalence of 2-3 of psoriasis in first-degree relatives of patients with Crohn s disease (CD) compared to 0 3 of controls; this association seemed to be less frequent for ulcerative colitis (UC) 4. Even if the association between psoriasis and IBD is well known, genes involving both conditions have not been found yet. However, the link between psoriasis and IBD is currently far from clear. There is evidence that T-helper cells of type 1 (Th1) and type 17 (Th17) and regulatory T-cells (T-regs) and the consequent cytokine pathway mediated by these cell populations such as TNF-, interleukin (IL)-1, IL-12/23 and IL-6 act at a systemic level, and can affect the intestine and the joints, metabolic pathways and the cardiovascular system. The aetiology of IBD necessitates an interaction between genetic factors and environmental precipitants, with disease hypothesised to rise in genetically susceptible individuals as a consequence of a dysregulated inflammatory response to intestinal microbes.

Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. The way doctors can tell the difference between Crohn’s disease and UC is the location and nature of the inflammatory changes. Further evidence of the role of gut flora in the cause of inflammatory bowel disease is that IBD-affected individuals are more likely to have been prescribed antibiotics in the 2-5 year period before their diagnosis than unaffected individuals. Association Between Inflammatory Bowel Disease and Vitamin D Deficiency: A Systematic Review and Meta-analysis. Objective To evaluate the relative risk of pulmonary disease among patients with psoriasis, psoriatic arthritis, and inflammatory bowel disease treated with methotrexate. Rare events require large patient numbers for conclusive evidence. Numerous case reports and observational studies have suggested a link between methotrexate and pulmonary disease. Inflammatory bowel diseases, Crohn’s disease and ulcerative colitis, are associated with a variety of extraintestinal manifestations. (AS), undifferentiated SpA, arthritis associated with acute anterior uveitis, psoriatic arthritis, reactive arthritis and idiopathic arthritis.

But it’s also important to recognize the evidence that’s out there about other conditions that occur with psoriatic arthritis. The link between psoriatic arthritis and eye problems is again inflammation, Azar says. Researchers know that the inflammation that occurs with psoriatic arthritis can contribute to the development of bowel conditions like Crohn’s disease, but they aren’t sure exactly how, says Elyse Rubenstein, MD, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, Calif. The basic distinctions between UC and CD are location and severity. People with Crohn’s disease have an increased risk for psoriasis. Rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and psoriasis are immune-mediated inflammatory diseases with similarities in pathophysiology, and all can be treated with similar biological agents. In most studies focusing on the relationship between gender and RA, women were found to have higher disease activity scores, more pain and greater loss of function, both in early and established disease 3 6. Thus, there is some evidence for gender differences in all three of these immune-mediated inflammatory diseases.

Inflammatory Bowel Disease

Apart from PsA, there is extensive evidence for the association of gut inflammation in all disease entities of SpAs to a greater or lesser extent (Mielants et al. Several studies demonstrate a link between psoriasis and metabolic syndrome.30,31 In 1999, the World Health Organization characterized metabolic syndrome as a combination of obesity, dyslipidemia, glucose intolerance, and elevated blood pressure. Crohn’s disease and ulcerative colitis are common chronic inflammatory diseases of the gastrointestinal system. There is also evidence in the literature that systemic treatments (eg, methotrexate and cyclosporine) lead to an increased occurrence of malignancies. These and other IBDs (inflammatory bowel disease) have been linked with an increased risk of colorectal cancer. However, there is no strong evidence that diet or stress cause Crohn’s disease or ulcerative colitis, although they can aggravate the conditions. People with Crohn’s disease have an increased risk for psoriasis. Difference between Symptoms of Mild and Severe Crohn’s Disease. Experimental evidence has begun to support this view, as barrier loss and its role in initiating and establishing a pathogenic inflammatory cycle in GVHD is emerging. Here we discuss similarities between IBD and GVHD, mechanisms of intestinal barrier loss in these diseases, and the crosstalk between barrier loss and the immune system, with a special focus on natural killer (NK) cells.